> that might appear to be incentive to improve quality

Their goal isn't to provide high quality care. Their goal is to increase profits. It's not hard to imagine how improved quality would lead them to spend more money. (faster diagnoses of serious illnesses and recommending expensive care)

Psychopaths don't care about other peoples pain. Some MBA only care about their own ego, power, and money. They do well in corporate cultures that reward parasitic relationships with customers. =3